Car Limousine Service - Corporate Limousine Service

Complete the following information to receive a FREE limousine quote. We provide limousine and car service in virtually ever major city in the world.

Type of Service

Vehicle Information

Vehicle Type

Contact Information

Full Name

Phone Number

E-mail address

Pick-up Location

Drop-off Location

Comments

Personal Information

Name:
Title:
Address:
City:
Home Phone:
Facsimile:

State:
Mobile:
E-mail:

Zip:
Work Phone:

Admin Assistant

Name:

Phone:
Extension:

E-mail:

Payment Information*

Corporate Card	Personal Card

Card Number:
Name on Card:
Invoicing Mailing Address:
City
Invoices Attn. of:

Invoices via mail

Expiration Date:
State:
Title:
Zip:

* A credit card must be on file, regardless of the payment method.

Proxy Information (please attach additional list if required)

Prime Time limousine, Inc.'s reservation and dispatch system is fully computerized. One of our unique features is that we can store pick-up and drop-off locations for individual users of an account. If you choose to provide us with the home addresses and usual drop-off locations for your account users, this information will automatically appear on your reservation screen each time a car is booked for that person.

Frequent Traveler information:

Name:
Drop-off Address:
City:
Pick-up Address:
City:

State:

State:

Zip:

Zip:

Terms & Conditions

All invoices must be paid in full within 30 days of invoice date. If invoices remain unpaid past 30 days, the full amount will be charged to the credit card provided on this agreement.

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